Subacromial decompression

Transcription

1 Subacromial decompression An information guide for patients Delivering the best in care UHB is a no smoking Trust To see all of our current patient information leaflets please visit

2 Shoulder anatomy and impingement The shoulder complex is made up of three bones; the humerus, scapula and clavicle. Ligament Clavicle Acromion Bursa Rotator cuff muscle and tendon Head of humerus Glenoid Labrum The tendons of your rotator cuff muscles and a bursa sit under the bony arch (acromion) above your shoulder joint. What is a subacromial decompression The operation aims to smooth out the bone on the underside of the acromion, effectively making the space bigger. The operation will be done under general anaesthetic and may be done arthroscopically (key hole surgery) or through an open incision. 2 PI_1107_02 Subacromial decompression

3 After the operation After the operation it may take up to three months for the inflammation in your shoulder to fully settle. It is important to keep your shoulder moving (as directed by your Physiotherapist) during this time. Pain It is normal to feel some pain following your operation. You will be given some painkillers and/or anti-inflammatory medication to take in the days following the operation. Using ice on your shoulder can be helpful in reducing pain. Wrap a bag of crushed ice, or frozen peas in a damp towel. Protect your dressings from getting wet with a layer of cling film, or a plastic bag, before applying the ice pack for minutes at a time. Posture can make a big difference to your pain after surgery. Avoid hitching your shoulder or holding it in an elevated position and try to avoid slumping or standing/sitting with round shoulders as this puts more stress onto your shoulder. Getting back to normal It is normal to feel more tired than usual for a few days after having an operation. Sleeping can be uncomfortable and it is important to try not to lie on your shoulder which has operated on. Using pillows to support your operated arm and maintain your posture when sleeping will help with the discomfort. Washing and dressing Dressings and bandages that are applied in theatre need to stay dry. Ensure that the area is dry before dressing to prevent irritation. It is easier to wear looser fitting clothes and dress by putting your operated arm into position in the top first. PI_1107_02 Subacromial decompression 3

4 Wound care Your wound also needs to stay clean and dry. If you have removable stitches they will be removed after days at an outpatient clinic appointment or by your GP. If dissolvable stitches are used, they will not need to be removed. Rehabilitation Rehabilitation is important if you are to get the most out of your shoulder after the operation. You should be given information about your first physiotherapy appointment before you leave hospital. The amount of physiotherapy you will need will depend on your individual progress and the level of activity you wish to return to. Returning to work The amount of time you have off work depends on your job. If you have a manual job, or one that involves lifting or overhead activities, you may not be able to do this for 8-12 weeks. Please discuss this with your Consultant or Physiotherapist. Driving When you are comfortable and have good range of movement in your shoulder you may return to driving. You must be able to comfortably control your vehicle and perform emergency manoeuvres. This may be as early as 1-2 weeks post surgery but you should discuss this further with your Consultant or Physiotherapist. Sports and activities The timescale for which you can go back to any previous sport or activity will depend on your movement and strength and the particular activity you have in mind. Please discuss returning to any activity or sport with your Consultant or Physiotherapist. 4 PI_1107_02 Subacromial decompression

5 Post-operative exercises With all of your exercises you should aim to repeat 10 repetitions, 3 times per day unless otherwise advised by your Physiotherapist. 1. Active hand, wrist and elbow 1 movements It is important to keep your hand, wrist and elbow moving after shoulder surgery. Clench your fist and spread your fingers wide Move your wrist up and down and side to side through its full range Bend and straighten your elbow through its full range of movement Slowly turn your forearm over so your palm is facing down and then facing up 2. Assisted shoulder flexion Sit up straight with shoulder blades pulled gently together Use your non-operated arm to assist your operated arm Slowly lift your operated arm towards 90 degrees. Do not force the movement Maintain a good posture and slowly lower your arms back to the start position 2 PI_1107_02 Subacromial decompression 5

6 3. Assisted external rotation Sitting with good posture, elbows supported on a table in front of you Hold a stick with palms facing down. Keep your elbows tucked into your side and slowly take the stick right to left across your body 3 Contact details If you have any questions regarding your operation or treatment, please do not hesitate to call us. Consultant secretaries Mr Kalogrianitis: Mr Massoud: PI_1107_02 Subacromial decompression

7 Please use the space below to write down any questions you may have and bring this with you to your next appointment. PI_1107_02 Subacromial decompression 7

8 The Trust provides free monthly health talks on a variety of medical conditions and treatments. For more information visit or call Physiotherapy Queen Elizabeth Hospital Birmingham Mindelsohn Way, Edgbaston, Birmingham, B15 2GW Telephone PI15/1107/02 Author: Julia Sawking, Caroline Miller, Nicola Birch Date: July 2015 Review date: July 2017